A 28-year-old G2P1 at 40 weeks is in active labor. She has a history of a previous cesarean section for breech presentation. At 6 cm dilation, she develops severe abdominal pain, fetal bradycardia, and vaginal bleeding. The most likely diagnosis is:
- A Cord prolapse
- B Placental abruption
- C Uterine rupture ✓
- D Amniotic fluid embolism
Correct answer: C. Uterine rupture
Explanation
C previous cesarean scar is a major risk factor for uterine rupture, which presents with severe pain, fetal bradycardia, and vaginal bleeding. Placental abruption can cause pain and bleeding but typically presents with uterine hypertonus and a rigid uterus. Cord prolapse presents with variable decelerations after membrane rupture. Amniotic fluid embolism causes sudden cardiovascular collapse.
Reference: Williams Obstetrics, 25th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.